CHARLES BRADLEY

By WALTER BROWN

Charles Bradley was born in Pittsburgh, Pennsylvania in 1902. He graduated from Cornell University and Harvard Medical School, served his internship at Pennsylvania Hospital and his residency at Babies Hospital in New York.

In the mid 1930s, Charles Bradley gave 30 children with psychological problems one week of treatment with the stimulant drug amphetamine sulphate (Benzedrine). Most of the children received a single morning dose of 20 mg, eight got 10 mg because they couldn’t tolerate 20 mg, and one received 30 mg. He carefully observed their behavior before, during and afterward. In 1937 he described the results of his study in a paper published in the American Journal of Psychiatry (1). Fourteen of these children, he wrote, underwent a “spectacular change in behavior. . .remarkably improved school performance.” He also noted that some of the children became subdued and their behavior more socially acceptable and others experienced a sense of well being. Bradley’s subsequent research and that of others confirmed the effects of psychostimulants on school performance and behavior (2). Bradley and his colleagues also identified a behavioral syndrome with a presumably “organic” basis, characterized by impulsivity, hypermotility and short “attention span” (3). This syndrome later became known as “minimal brain dysfunction,” “hyperkinetic impulse disorder,” “hyperkinetic reaction of childhood,” and finally “attention deficit hyperactivity disorder” (ADHD). Twenty years after Bradley’s initial observations (1), colleagues at Bradley Hospital showed the specific benefit of psychostimulants in the treatment of ADHD (4). Bradley’s 1937observation now stands among the most important psychiatric treatment discoveries.

Charles Bradley made this discovery while serving as Medical Director of the Emma Pendleton Bradley Home-now Bradley Hospital-in East Providence, Rhode Island. The Bradley Home - founded by George Bradley, Charles’s great-uncle, and named for George Bradley’s neurologically impaired daughter, Emma - opened in 1931 to treat children with nervous disorders. A year later, Charles Bradley, fresh out of his training in child psychiatry, joined its staff.

The Benzedrine discovery was a byproduct of the thorough neurological evaluations carried out under Bradley’s direction, which included pneumoencephalography. Bradley began treating children who suffered postpneumoencephalography headaches, presumably due to spinal fluid loss, with Benzedrine, speculating that because Benzedrine is a stimulant it would stimulate the choroid plexus to produce spinal fluid.

The Benzedrine did not do much for the headaches, but teachers noticed that some of the children taking Benzedrine experienced a striking improvement in their schoolwork. The children themselves noticed the improvement, particularly in math, and dubbed the medicine “arithmetic pills.” Bradley pursued this observation in the controlled trial that confirmed Benzedrine’s effect on school performance.

Like many other important medical discoveries, Bradley’s was accidental. He used a drug for the wrong reason in the wrong condition and got a totally unexpected result. His genius was in recognizing the importance of the unexpected result and pursuing it.